摘要
目的了解大型综合医院住院费用结构变动趋势及特征,为控制住院费用不合理增长提供依据。方法收集广西某三甲综合医院2014~2016年的住院患者费用资料,运用结构变动值、结构变动度和结构贡献率等指标进行分析。结果 2014~2016年,三甲医院住院总费用逐年上升,但增速下降,增幅较小。药品费和卫生材料费占住院总费用比例名列前2位。2014~2016年药品费、检查费、诊察费、床位费、治疗费和护理费的结构变动值呈负向变动;化验费、卫生材料费、手术费和其他费用的结构变动值则呈正向变动。药品费和卫生材料费对住院费用变动贡献较大,2项累积贡献率达47.06%。结论药费控制政策措施初见成效,但药占比仍较高,还需加强对药品费的管控。住院费用结构不合理,卫生材料费、化验费等比重较高,而体现医护人员技术劳务价值的手术费、护理费等占比较低,费用结构有待调整与优化。
Objective To analysis the trend and characteristics of hospitalization expenses structure change in a gradeⅢ level A general hospital, and provide evidence for the unreasonable increase of hospitalization expenses. Methors The hospitalization expenses of patients in a grade Ⅲ level A general hospital from 2014 to 2016 were collected by analyzing the structure changes value, degree of structure variation and structure contribution rate. Results The total hospitalization expenses of the top three hospitals increased year by year from 2014 to 2016, but the growth rate decreased. The proportion of medical expenses and medical materials expenses accounted for the total hospitalization expenses of top 2. The value of negative changes in structure of 2014-2016 medicine fees, examination fees,examination fees, bed charges, treatment fees and nursing; value positive changes in the structure of health laboratory fees, material fee, operation fee and other expenses. The cost of medicine and medical materials contribute greatly to the change of hospitalization expenses. The cumulative contribution rate of these 2 items was 47.06%. Conclusion Expenses control policies for medicine has achieved initial success, but the proportion of medicine expenses is still high which still need to strengthen the medicine expenses control. The structure of hospitalization expenses is unreasonable. The proportion of medical materials and laboratory fees are high. However, the cost of operation and nursing care which reflects the technical labor value of medical staff is relatively low. Expenses structure needs to be adjusted and optimized.
作者
冯俊
李英利
徐婷婷
高洪达
覃娴静
冯启明
王建政
FENG Jun;LI Yingli;XU Tingting;GAO Hongda;QIN Xianjing;FENG Qiming;WANG Jianzheng(School of Information and Management, Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning 530021, China;School of Humanities and management, Guilin Medical College, Guangxi Zhuang Autonomous Region, Guilin 541004, China;Guangxi Zhuang Autonomous Region Health and Family Planning Commission, Guangxi Zhuang Autonomous Region, Nanning 530021, China)
出处
《中国医药导报》
CAS
2018年第13期147-150,共4页
China Medical Herald
基金
广西医改办委托项目
关键词
住院费用
结构变动度
费用控制
大型医院
Hospitalization expenses
Structural variability degree
Expenses control
General hospital
